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英：akathisia 独：Akathisie 仏：akathisie | 英：akathisia 独：Akathisie 仏：akathisie | ||
{{box|text= | {{box|text= アカシジアは静座不能に対する自覚的な内的不穏症状と、身体の揺り動かし、足踏み、足の組み換えなどの客観的な運動亢進症状から成る病態の一群である。歴史的には精神症状の病態として報告が集積されてきたが、統合失調症に対して抗精神病薬が広く使用されるようになってからは、薬原性アカシジアの報告が多くなってきた。アカシジアの発症頻度は抗精神病薬を服用中の患者の5-70%と服用している薬剤の種類や用量、投与期間によってばらつきがみられる。アカシジアを引き起こす代表的な薬剤として抗精神病薬や小胞モノアミントランスポーター2阻害薬があげられる。中枢ドパミン神経系の阻害がアカシジアの主要な病態生理と考えられているが、他の作用機序の関与も想定されている。鑑別すべき病態として、不安・焦燥感・常同行動などの精神症状、むずむず脚症候群、遅発性ジスキネジアが挙げられる。薬原性アカシジアの治療は医薬品副作用に対する治療の大原則に沿って、原因薬剤の減量・中止や副作用のより少ない他の薬剤への変更を試みるが、それでも改善しない場合には、対照療法薬としてβ遮断薬、セロトニン5HT2A遮断薬、ベンゾジアゼピン系薬剤、抗コリン薬等が使用される。 | ||
Akathisia consists of subjective inner restlessness, such as awareness of the inability to remain seated, restless legs, fidgetiness, and the desire to move constantly, and of objective increased motor phenomena, such as body rocking, shifting from foot to foot, stamping in place, crossing and uncrossing legs, pacing around. Historically, akathisia has been reported as a psychiatric condition, but since the widespread use of antipsychotic drugs for schizophrenia, reports of drug-induced akathisia have increased. Its prevalence varies ranging from 5-70% depending on the dosage, duration, and the drug used. Drugs that typically cause akathisia include antipsychotics and vesicular monoamine transporter 2 inhibitors. Inhibition of the central dopaminergic nervous system is thought to be the primary pathophysiology of akathisia, although other mechanisms of action have also been postulated. Differentiating conditions include restless leg syndrome, tardive dyskinesia, and psychiatric symptoms such as anxiety, agitation, and stereotyped behaviors. The fundamental treatment for acute akathisia is the reduction or withdrawal of antipsychotic medication, then switching to medications with fewer development of akathisia. However, this is often not possible because of worsening mental conditions in psychiatric patients. For these cases, beta-adrenoceptor blockers, benzodiazepines, serotonin 2A receptor antagonists, and anticholinergic agents have been used for the treatment of this condition.}} | Akathisia consists of subjective inner restlessness, such as awareness of the inability to remain seated, restless legs, fidgetiness, and the desire to move constantly, and of objective increased motor phenomena, such as body rocking, shifting from foot to foot, stamping in place, crossing and uncrossing legs, pacing around. Historically, akathisia has been reported as a psychiatric condition, but since the widespread use of antipsychotic drugs for schizophrenia, reports of drug-induced akathisia have increased. Its prevalence varies ranging from 5-70% depending on the dosage, duration, and the drug used. Drugs that typically cause akathisia include antipsychotics and vesicular monoamine transporter 2 inhibitors. Inhibition of the central dopaminergic nervous system is thought to be the primary pathophysiology of akathisia, although other mechanisms of action have also been postulated. Differentiating conditions include restless leg syndrome, tardive dyskinesia, and psychiatric symptoms such as anxiety, agitation, and stereotyped behaviors. The fundamental treatment for acute akathisia is the reduction or withdrawal of antipsychotic medication, then switching to medications with fewer development of akathisia. However, this is often not possible because of worsening mental conditions in psychiatric patients. For these cases, beta-adrenoceptor blockers, benzodiazepines, serotonin 2A receptor antagonists, and anticholinergic agents have been used for the treatment of this condition.}} | ||